United States Facts Economic Costs Due to Smoking: $157,726,000,000 Adult Prevalence: 22.5% High School Smoking Rate: 21.9% Middle School Smoking Rate: 10.1% Smoking Attributable Deaths per 100,000 Population: 295.5 Smoking Attributable Lung Cancer: 90.2 Adult prevalence data is taken from the CDC National Health Interview Survey, 2002. High school rates are taken from the 2003 Youth Risk Behavioral Surveillance System. Middle school rates are taken from the 2002 Youth Tobacco Survey. Health impacts information for 1999 is taken form the Smoking Attributable Mortality, Morbidity and Economic Costs (SAMMEC) software. Age-adjusted rates were calculated for persons aged 35 years and older and were age-adjusted to the 2000 U.S. population. Health impacts includes direct medical expenditures as well as lost productivity costs.

American Lung Association American Lung Association National Headquarters 61 Broadway New York, NY 10006 Phone: (212) 315-8700 Fax: (212) 315-8870

NATIONAL
BEHIND THE SCENES
This year, Congress had a historic opportunity to move forward with a comprehensive federal tobacco control
policy but, unfortunately, failed on all counts to adequately protect public health.

In 2004, strong bipartisan legislation was introduced by Sens. Mike DeWine (R-OH) and Ted Kennedy (D- MA) and Reps. Tom Davis (R-VA) and Henry Waxman (D-CA) to give the Food and Drug Administration (FDA) the authority to regulate the contents and advertising of tobacco products. More that 540 national, state, and local public health organizations endorsed this legislation.

In late July, the FDA legislation—along with a tobacco grower buy-out—was attached to a corporate tax bill, the Foreign Sales Corporation (FSC) bill. This legislation passed the Senate overwhelmingly, 78-15. Although the Senate was resolute in its support of FDA coupled with a tobacco company-paid buy-out, the FDA provision did not prevail. The House of Representatives and Senate conference
committee chaired by Rep. Bill Thomas (R-CA) drafted the proposed final bill with the tobacco quota buy-out and without the FDA regulation provision. When the committee met, the House conferees rejected Senate amendments to include FDA authority in the final bill. The conference committee then approved the bill without the FDA authority.

In order to move the tax bill, the Senate voted to pass a stand-alone FDA bill (S 2974), known as the Family Smoking Prevention and Tobacco Control Act, on October 10, 2004. Unfortunately, the leadership of the House of Representatives continues to block consideration of this vital public health legislation despite strong bipartisan support with over 80 cosponsors of the House version (HR 4433). On October 22, 2004, President Bush signed the tax bill, including the $10 billion tobacco quota buy-out into law.

In 2003 the Subcommittee on Cessation of the Interagency Committee on Smoking and Health (ICSH) issued a National Action Plan for Tobacco Cessation. The National Action Plan contains bold, science-based steps for the federal government to undertake to achieve a dramatic reduction in tobacco use rates in America. The plan proposed a national quitline network, national media campaign, federal coverage of cessation benefits, and a smokers’ fund to assist people trying to quit. The plan also called for an increase in the federal cigarette tax to $2.00 per pack. To date, the only recommendation to be implemented is the national quitline. Unfortunately it is woefully underfunded. At the international level, the United States failed to move forward on an international tobacco control treaty—the Framework Convention on Tobacco Control (FCTC). In May, the United States signed the FCTC. However, the president has not submitted the treaty to the Senate for ratification and it remains languishing on his desk. Due to the inaction of the United States to ratify the treaty, the United States will not be able to participate in the implementation and the public health benefits of the treaty.In 2005, the American Lung Association will continue to work for strong FDA regulation of tobacco products. The overwhelming Senate vote in favor of the legislation in 2004 is a powerful indication of the support in Congress for strong legislation. In addition, the American Lung Association will push for implementation of the National Action Plan for Tobacco Cessation and ratification of the FCTC.